Prosthetic rehabilitation of a patient with gastroesophageal reflux disease: 4-year followup

The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.

Estética em sistema metal free associado a núcleos metalocerâmicos personalisados

The evolution of ceramic systems currently allows the manufacture of prosthesis similar to the natural teeth, meeting the expectations of patients. However, when using vitreous ceramic the color of substrate is significant for the esthetic result, requiring planning aesthetic cores when involved reconstruction of endodontically treated teeth without coronal structure. Thus, the aim of this study to describe a case report of aesthetic rehabilitation in upper anterior teeths using vitreous ceramic system for the reconstruction of elements: 11, 12, 21 and 22 after endodontically treated. It was emphasized the removal of crowns and manufacture of custom cast post and core with ceramic in coronal portion, prioritizing the aesthetic result. Through the clinical results observed can be seen that the use of custom cast post and core with ceramic in association lithium disilicate glass ceramics provided a satisfactory aesthetic result.

Restaurações cerâmicas minimamente invasivas executadas por cirurgiões dentistas com diferentes níveis de experiência profissional: estudo clínico cego, longitudinal e prospectivo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo clínico retrospectivo de restaurações cerâmicas do tipo laminado sobre dentes com ou sem preparo dentário: 1 a 5 anos de acompanhamento

Pós-graduação em Odontologia - FOA

Comportamento biomecânico de estruturas multicamadas em restaurações protéticas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos de lasers de alta potência na superfície de cerâmicas vítreas de dissilicato de lítio e sua resistência de união à dentina humana

Pós-graduação em Odontologia Restauradora - ICT

Efeitos de lasers de alta potência na superfície de cerâmicas vítreas de dissilicato de lítio e sua resistência de união à dentina humana

Pós-graduação em Odontologia Restauradora - ICT

Relationship between elastic and mechanical properties of dental ceramics and their index of brittleness

The purpose of the study was to verify the effects of a number of materials' parameters (crystalline content; Young's modulus, E; biaxial flexure strength, sigma(i); Vickers hardness, VH; fracture toughness, K-Ic; fracture surface energy, gamma(f); and index of brittleness, B) on the brittleness of dental ceramics. Five commercial dental ceramics with different contents of glass phase and crystalline particles were studied: a vitreous porcelain (VM7/V), a porcelain with 16 vol% leucite particles (d.Sign/D), a glass-ceramic with 29 vol% leucite particles (Empress/E1), a glass-ceramic with 58 vol% lithium-disilicate needle-like particles (Empress 2/E2), and a glass-infiltrated alumina composite with 65 vol% crystals (In-Ceram Alumina/IC). Discs were constructed according to manufacturers' instructions, ground and polished to final dimensions (12 mm x 1.1 mm). Elastic constants were determined by ultrasonic pulse-echo method. sigma(i) was determined by piston-on-3-balls method in inert condition. VH was determined using 19.6 N load and K-Ic was determined by indentation strength method. gamma(f) was calculated from the Griffith-Irwin relation and B by the ratio of HV to K-Ic. IC and E2 showed higher values of sigma(i), E, K-Ic and gamma(f), and lower values of B compared to leucite-based glass-ceramic and porcelains. Positive correlations were observed for sigma(i) versus K-Ic, and K-Ic versus E-1/2, however, E did not show relationship with HV and B. The increase of crystalline phase content is beneficial to decrease the brittleness of dental ceramics by means of both an increase in fracture surface energy and a lowering in index of brittleness. (C) 2012 Elsevier Ltd and Techna Group Sri. All rights reserved.

Molekulardynamiksimulationen zur Untersuchung des Mischalkali-Effektes in silikatischen Gläsern

In der vorliegenden Arbeit wird mittels Molekulardynamik(MD)-Computersimulationen die Dynamik von verschiedenen Alkalisilikaten in der Schmelze und im Glas untersucht. Es ist bekannt, daß diese Systeme ionenleitend sind, was auf eine hohe Mobilität der Alkaliionen im Vergleich zu den glasbildenden Komponenten Si und O zurückzuführen ist. Im Mittelpunkt des Interesses steht der sog. Mischalkalieffekt (MAE), der in ternären Mischungen aus Siliziumdioxid mit zwei Alkalioxiden auftritt. Gegenüber Mischungen mit nur einer Alkaliionensorte weisen letztere Systeme eine signifikante Verlangsamung der Alkaliionendiffusion auf. Zunächst werden zwei binäre Alkalisilikate simuliert, nämlich Lithiumdisilikat (LS2) und Kaliumdisilikat (KS2). Die Simulationen zeigen, daß der Ursprung der hohen Mobilität der Alkaliionen in der Struktur begründet ist. KS2 und LS2 weisen auf intermediären Längenskalen Ordnung auf, die in partiellen statischen Strukturfaktoren durch Prepeaks reflektiert ist. Die den Prepeaks zugrundeliegende Struktur erklärt sich durch perkolierende Netzwerke aus alkalioxidreichen Kanälen, die als Diffusionskanäle für die mobilen Alkaliionen fungieren. In diesen Kanälen bewegen sich die Ionen mittels Sprüngen (Hopping) zwischen ausgezeichneten Plätzen. In der Simulation beobachtet man für die hohen Temperaturen (4000K>=1500K) eine ähnliche Aktivierungsenergie wie im Experiment. Im Experiment findet allerdings unterhalb von ca.1200K ein Crossover in ein Arrheniusverhalten mit höherer Aktivierungsenergie statt, welches von der Simulation nicht nachvollzogen wird. Das kann mit der in der Simulation nicht im Gleichgewicht befindlichen Si-O-Matrix erklärt werden, bei der Alterungseffekte beobachtet werden. Am stärksten ist der MAE für eine Alkalikomponente, wenn deren Konzentrationsanteil in einem ternären Mischalkalisystem gegen 0 geht. Daher wird ein LS2-System untersucht, in dem ein Li-Ion gegen ein K-Ion getauscht wird. Der Einfluß des K-Ions ist sowohl lokal in den charakteristischen Abständen zu den ersten nächsten Nachbarn (NN) zu sehen, als auch in der ortsaufgelösten Koordinationszahlverteilung bis zu Längenskalen von ca. 8,5 Angstrom. Die Untersuchung der Dynamik des eingesetzten K-Ions zeigt, daß die Sprungwahrscheinlichkeit nicht mit der Lokalisierung, einem Maß für die Bewegung eines Teilchens um seine Ruheposition, korreliert ist, aber daß eine chemische Umgebung mit wenig Li- und vielen O-NN oder vielen Li- und wenig O-NN ein Sprungereignis begünstigt. Zuletzt wird ein ternäres Alkalisilikat (LKS2) untersucht, dessen Struktur alle charakteristischen Längenskalen von LS2 und KS2 aufweist. Es stellt sich also eine komplexe Struktur mit zwei perkolierenden Subnetzwerken für Alkaliionen ein. Die Untersuchung der Dynamik zeigt eine geringe Wahrscheinlichkeit dafür auf, daß Ionen in ein Subnetzwerk andersnamiger Ionen springen. Auch kann gezeigt werden, daß das Modellpotential den MAE reproduzieren kann, daß also die Diffusionskonstanten in LKS2 bei bis zu einer Größenordnung langsamer sind als in KS2 bzw. LS2. Der beobachtete Effekt stellt sich zudem vom funktionalen Verlauf her so dar, wie er beim MAE erwartet wird. Es wurde auch festgestellt, daß trotz der zeitlichen Verzögerung in den dynamischen Größen die Anzahl der Sprünge pro Zeit nicht geringer ist und daß für niedrige Temperaturen (d.h.im Glas) Sprünge auf den Nachbarplatz mit anschließendem Rücksprung auf die vorherige Position deutlich wahrscheinlicher sind als bei hohen Temperaturen (also in der Schmelze). Die vorliegenden Resultate geben Aufschluß über die Details der Mechanismen mikroskopischer Ionenleitung in binären und ternären Alkalisilikaten sowie dem MAE.

Studio degli effetti della mordenzatura con acido fluoridrico sul disilicato di litio utilizzato in odontoiatria

Scopo dello studio: valutare i cambiamenti indotti da diversi trattamenti di mordenzatura sulla morfologia superficiale e sulla microstruttura di due vetro-ceramiche a base disilicato di litio (IPS e.max® Press e IPS e.max® CAD) ed esaminarne gli effetti sia sull’adesione con un cemento resinoso che sulla resistenza alla flessione. Materiali e metodi: Settanta dischetti (12 mm di diametro, 2 mm di spessore) di ogni ceramica sono stati preparati e divisi in 5 gruppi: nessun trattamento (G1), HF 5% 20s (G2), HF 5% 60s (G3), HF 9.6% 20s (G4), HF 9.6% 60s (G5). Un campione per ogni gruppo è stato analizzato mediante profilometro ottico e osservato al SEM. Per gli altri campioni è stato determinato lo shear bond strength (SBS) con un cemento resinoso. Dopo l’SBS test, i campioni sono stati caricati fino a frattura utilizzando il piston-on-three-ball test per determinarne la resistenza biassiale alla flessione. Risultati: L’analisi morfologica e microstrutturale dei campioni ha rivelato come diversi trattamenti di mordenzatura producano delle modifiche nella rugosità superficiale che non sono direttamente collegate ad un aumento dei valori di adesione e dei cambiamenti microstrutturali che sono più rilevanti con l’aumento del tempo di mordenzatura e di concentrazione dell’acido. I valori medi di adesione (MPa) per IPS e.max® CAD sono significativamente più alti in G2 e G3 (21,28 +/- 4,9 e 19,55 +/- 5,41 rispettivamente); per IPS e.max® Press, i valori più elevati sono in G3 (16,80 +/- 3,96). La resistenza biassiale alla flessione media (MPa) è più alta in IPS e.max® CAD (695 +/- 161) che in IPS e.max® Press (588 +/- 117), ma non è non influenzata dalla mordenzatura con HF. Conclusioni: il disilicato di litio va mordenzato preferibilmente con HF al 5%. La mordenzatura produce alcuni cambiamenti superficiali e microstrutturali nel materiale, ma tali cambiamenti non ne influenzano la resistenza in flessione.

All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns (SCs).

OBJECTIVE To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported single crowns (SCs) and to describe the incidence of biological, technical and esthetic complications. METHODS Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported fixed dental prostheses (FDPs) with a mean follow-up of at least 3 years. This was complimented by an additional hand search and the inclusion of 34 studies from a previous systematic review [1,2]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS Sixty-seven studies reporting on 4663 metal-ceramic and 9434 all-ceramic SCs fulfilled the inclusion criteria. Seventeen studies reported on metal-ceramic crowns, and 54 studies reported on all-ceramic crowns. Meta-analysis of the included studies indicated an estimated survival rate of metal-ceramic SCs of 94.7% (95% CI: 94.1-96.9%) after 5 years. This was similar to the estimated 5-year survival rate of leucit or lithium-disilicate reinforced glass ceramic SCs (96.6%; 95% CI: 94.9-96.7%), of glass infiltrated alumina SCs (94.6%; 95% CI: 92.7-96%) and densely sintered alumina and zirconia SCs (96%; 95% CI: 93.8-97.5%; 92.1%; 95% CI: 82.8-95.6%). In contrast, the 5-year survival rates of feldspathic/silica-based ceramic crowns were lower (p<0.001). When the outcomes in anterior and posterior regions were compared feldspathic/silica-based ceramic and zirconia crowns exhibited significantly lower survival rates in the posterior region (p<0.0001), the other crown types performed similarly. Densely sintered zirconia SCs were more frequently lost due to veneering ceramic fractures than metal-ceramic SCs (p<0.001), and had significantly more loss of retention (p<0.001). In total higher 5 year rates of framework fracture were reported for the all-ceramic SCs than for metal-ceramic SCs. CONCLUSIONS Survival rates of most types of all-ceramic SCs were similar to those reported for metal-ceramic SCs, both in anterior and posterior regions. Weaker feldspathic/silica-based ceramics should be limited to applications in the anterior region. Zirconia-based SCs should not be considered as primary option due to their high incidence of technical problems.

Évaluation de l’effet de "Streptococcus mutans" sur la qualité du fini de surface de matériaux dentaires de restauration

Objectif : Évaluer l’impact de l’exposition d’un biofilm de Streptococcus mutans (S. mutans) pendant une période de 28 jours sur la rugosité de surface de matériaux de restauration dentaire. Matériel et méthode : Les matériaux testés étaient : six résines composites (fluide, bulk-fill fluide, microparticules, nanoparticules, microhybride et nanohybride), un verre ionomère conventionnel, un verre ionomère modifié à la résine, de l’amalgame, du disilicate de lithium et de la porcelaine feldspathique renforcie de cristaux de nanoleucite. Cent soixante-dix-sept disques de 5 mm de diamètre par 2 mm d’épaisseur ont été fabriqués et polis selon une méthode standardisée. Des répliques ont été fabriquées puis réservées pour les mesures de rugosité. Les échantillons ont été stérilisés puis placés dans un milieu de culture pendant 28 jours, avec S. mutans pour les groupes tests et sans S. mutans pour leurs contrôles. Le milieu de culture a été renouvelé toutes les 48 heures. De nouvelles répliques des échantillons ont été fabriquées. Finalement, la rugosité de la surface avant et après l’exposition au biofilm a été évaluée sur les répliques à l’aide d’un profilomètre. Les analyses statistiques ont été effectuées à l’aide d’un modèle d’analyse de variance à deux facteurs. Résultats : Aucune différence statistiquement significative n’a été notée entre la rugosité initiale et finale des groupes tests et des groupes contrôles (p < 0,05). Conclusion : Dans les limites de cette étude in vitro, l’exposition à un biofilm de S. mutans pendant 28 jours n’a pas démontré avoir d’impact sur la rugosité des matériaux testés.

Dissilicato de lítio

De forma a completar as necessidades estéticas, que são cada vez mais exigidas pela sociedade, as cerâmicas dentárias têm apresentado rápida evolução com o intuito de melhorar as suas propriedades físicas e mecânicas, como também óticas. O desenvolvimento de novos materiais permitiu a aplicação e o progresso dos sistemas totalmente cerâmicos utilizados na área da medicina dentária. Pelas suas características estéticas relativamente aos sistemas metalocerâmicos, rapidamente os sistemas totalmente cerâmicos ocuparam o seu lugar no mercado, levando à atenção de médicos dentistas, como dos próprios pacientes. Dentro destes sistemas totalmente cerâmicos, encontra-se a cerâmica reforçada com dissilicato de lítio. Esta revisão narrativa da literatura teve como objetivo descrever as características da cerâmica dissilicato de lítio de forma a tornar possível compreender em que situações clinicas poderá ser utilizada, bem como, de que forma é possível otimizar os processos laboratoriais. Para tal, foram utilizadas várias bases de dados, Pubmed, Scielo, JADA, e Science Direct, utilizando como palavras-chave: “Ceramic”, “Dental Ceramic” “Porcelain”, “Lithium Dissilicate”; “IPS e.max

Devem as porcelanas serem re-silanizadas após a contaminação?

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2015.

Avaliação in vitro da adaptação marginal e interna de coroas de cerâmica e resina composta fabricadas com o sistema CAD/CAM utilizando duas câmeras intraorais de moldagem digital

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2015.